Provider Demographics
NPI:1982889846
Name:CAPELL, CARRIE LYNN (MS CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:LYNN
Last Name:CAPELL
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:LYNN
Other - Last Name:SHARRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:164 PARKINGWAY ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5020
Mailing Address - Country:US
Mailing Address - Phone:617-733-4222
Mailing Address - Fax:
Practice Address - Street 1:164 PARKINGWAY ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5020
Practice Address - Country:US
Practice Address - Phone:617-733-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist